| NPI | 1417359167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS016552) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: DE B1-0000957) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2014-10-24 |